MEDICARE: DR. CHRISTOPHER WONG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	102726	CA

General Provider Information

NPI Number	:	1063980597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER WONG DDS

Provider Business Mailing Address
First Line	:	409 CAMBRIDGE AVE
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-1614
Country	:	US
Telephone Number	:	650-326-6319
Fax Number	:	650-326-1572

Provider Business Practice Location Address
First Line	:	409 CAMBRIDGE AVE
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94306-1614
Country	:	US
Telephone Number	:	650-326-6319
Fax Number	:	650-326-1572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2018
Last Update Date	:	12/10/2025

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